Adaptación al castellano y validación del cuestionario Arthritis Treatment Satisfaction Questionnaire / Linguistic adaptation into Spanish and validation of the Arthritis Treatment Satisfaction Questionnaire

RESUMEN

Fundamento y objetivo: Adaptación lingüística y validación al castellano del cuestionario ARTS (Arthritis Treatment Satisfaction Questionnaire), instrumento autoadministrado que mide cuatro dimensiones de satisfacción con el tratamiento de la artrosis: eficacia, conveniencia, tolerabilidad y cuidado médico. Material y método: La adaptación se llevó a cabo mediante equivalencia conceptual, fue supervisado por 6 expertos y 4 traductores que tradujeron y retrotradujeron los ítems. Se utilizó una muestra de pacientes con artrosis de rodilla, cadera o columna cervical para estimar las propiedades psicométricas de factibilidad, fiabilidad, validez y sensibilidad al cambio. Se identificaron 3 grupos: escaso efecto analgésico, escasa tolerabilidad y adecuado efecto analgésico y tolerabilidad. El ARTS se administró basalmente, a la semana, y después de 4 semanas de tratamiento con antiinflamatorios no esteroideos o con inhibidores de la ciclooxigenasa 2. Resultados: Se incluyó a 163 pacientes de edad media (DE) de 67,7 (9,2) años. No se observó efecto suelo o techo, los ítems se entendieron correctamente y las tasas de ausencia de respuesta resultaron inferiores al 1%, con un * de Cronbach de 0,85 y coeficiente de correlación intraclase de 0,81. El análisis factorial exploratorio mostró cuatro dimensiones coherentes con la versión original. La validez concurrente se evaluó con la escala SF-36, la escala EVA de dolor, la escala EVA de cumplimiento terapéutico y el cuestionario de Morisky-Green. El cuestionario adaptado mostró también una buena validez discriminante, y fue capaz de distinguir entre pacientes que requieren cambio de tratamiento. También demostró sensibilidad al cambio en la efectividad del tratamiento tras 30 días de seguimiento. Conclusiones: La versión adaptada del cuestionario ARTS es psicométricamente válida y conceptualmente equivalente para explorar la satisfacción con el tratamiento de la artrosis en lengua española

ABSTRACT

Background and objective: Linguistic adaptation and validation into Spanish of the ARTS questionnaire, a self reported instrument designed to measure four osteoarthritis treatment satisfaction dimensions: treatment advantages, treatment convenience, apprehension about treatment and satisfaction with medical care. Material and method: Adaptation was performed using conceptual equivalence, supervised by a panel of 6 experts and 4 independent translators, who were in charge of performing translation and back-translation of the items. A sample of patients suffering from knee, hip or column osteoarthritis was used to estimate the psychometric properties of feasibility, reliability, validity and sensitivity to change. Three groups were identified: adequate analgesic effect and tolerability, treatment-switch because of a weak analgesic effect, and treatment- switch due to poor tolerability. The ARTS was administered at baseline, 1 week later for retest, and after 4 weeks of treatment with NSAIDs or Cox II-inhibitors. Results: A sample of 163 patients was formed (67.7 [9.2] years old). No floor or ceiling effects were found, items were well understood and non- response rates were below 1%. Cronbach's alpha for the total scales was 0.85, and the intraclass correlation coefficient was 0.81. Exploratory factor analysis yielded 4 dimensions which were coherent with those proposed by the original authors. Concurrent validity was measured with SF-36, a pain VAS instrument, a treatment compliance VAS, and the Morisky-Green compliance questionnaire. The adapted instrument showed a good discriminatory validity, and it was able to distinguish between patients needing a change in treatment and those who did not need it. It was also sensitive to changes in patients' treatment effectiveness after a 30 days follow up. Conclusions: A psychometrically valid and conceptually equivalent ARTS questionnaire has been produced to explore satisfaction with treatment in patients with osteoarthritis in Spanish speaking countries